Doctors, midwives and health professionals from every region of the world today added their voices to the growing pressure for the decriminalisation of abortion, with 838 from 44 countries signing an open letter to governments, published today by Amnesty International.

The letter calls on governments, including those of Ireland and Northern Ireland, to stop interfering with health professionals’ ability to provide care, warning that criminalising abortion puts women and girls’ health and lives at risk.

“It impedes and disregards sound medical judgment and can undermine the professional duty of care and confidentiality that doctors bear towards their patients.”

Globally, 40% of women of childbearing age live in countries where abortion is banned, highly restricted or otherwise inaccessible. Unsafe abortion accounts for 13% of maternal deaths, resulting in 47,000 women and girls dying each year. It leaves five million with lifelong injuries.

“The message from hundreds of health professionals worldwide is clear; women are not criminals and criminalising abortion endangers their health and, in some cases, their lives.

“Medical professionals need space to make clinical decisions without the threat of prosecution. It’s time governments treated abortion for what it is; a healthcare and human rights issue, not a criminal act.

“Ireland’s laws, north and south, are a matter for global embarrassment and fall desperately short of international human rights law. At the very least women should have access to an abortion when the pregnancy is a result of rape or incest and in cases of severe or fatal foetal impairment. Women are not vessels, it’s time we stopped treating them as such.”

In numerous countries around the world, Amnesty has documented shocking cases of women forced to continue unviable pregnancies because of restrictive laws. Amnesty’s research has documented women and girls pregnant as a result of rape forced to carry the foetus to term and give birth.

Breedagh Hughes from the Royal College of Midwives who said:

“Today’s letter makes a mockery of any government’s claim that the criminalisation of abortion has no impact on the health care that their citizens receive. Everyday midwives and medics work with women, often with planned and wanted pregnancies, who have received devastating news that their feotus will not survive. It is immensely frustrating that we are not able to give them the care they require.

“Laws in Ireland and Northern Ireland do not stop women seeking or needing abortions, instead it forces them to travel to England or elsewhere to receive the healthcare or resort to desperate, often dangerous, measures.

Amnesty International’s global My Body My Rights campaign aims to stop the control and criminalisation of sexuality and reproduction by governments. It has highlighted the situation in El Salvador, Ireland and Chile, three countries where legal barriers to abortion severely limit doctors’ ability to provide women the healthcare they need.

Doctors in Ireland, El Salvador and many other countries have spoken to Amnesty International of the restrictions abortion laws place on their ability to provide care to their patients.

Ireland
Doctors and health care providers in the Republic of Ireland may face up to 14 years in jail if they provide, or assist in providing, an abortion other than when a woman or girl’s life is at risk, even where they act to protect her health.

In a June 2015 report, doctors told Amnesty International that they face a choice of either breaking the law or providing potentially dangerous – and unethical – care to their patients.

Dr. Peter Boylan, an obstetrician, gynaecologist and former Master and Clinical Director of Ireland’s National Maternity Hospital told Amnesty International about the legal and ethical tightrope medical staff are forced to walk:

“Under the [current law] we must wait until women become sick enough before we can intervene. How close to death do you have to be? There is no answer to that.”

Northern Ireland

Doctors, midwives and other healthcare providers face life imprisonment if they provide or assist in providing, an abortion other than when a woman or girl’s life is at risk or where there is a long term risk to her physical and mental health. The criminal penalties in Northern Ireland are the harshest in Europe.

El Salvador
Health professionals in El Salvador risk prosecution and imprisonment of six to 12 years for providing abortion services, under any circumstances. As a result, they are reduced to monitoring the woman’s condition for sufficient deterioration before undertaking any procedure, which could harm the foetus, according to an Amnesty International report issued in September 2014.

A doctor working in a maternal health unit in a public hospital in El Salvador told Amnesty International how the law prevents doctors from acting if complications during pregnancy threaten a woman’s health:

“We’re not discussing a medical question, but a purely legal one. We all know what needs to be done, but we go back to the fact that we all have our hands tied by what is written in the law.”

Chile
In Chile, under the Criminal Code health professionals risk prison for assisting or carrying out an abortion. Health professionals themselves often report abortions to the police.

Obstetrician René Castro highlighted the problems caused by having to wait until there is an imminent danger before being able to take action:

“Today there is a much greater consensus internationally when talking about quality of life. The issue is whether I wait until a woman is in intensive care because of a grave complication of a pre-existing condition before taking action, or whether I’m going to forestall this serious episode and accept it when a woman tells me ‘doctor, I’d prefer to terminate the pregnancy before I get to that point’” because “the focus should be on the woman’s own decision”.

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